Massive weight loss may facilitate otherwise impossible flap designs in phalloplasty: The first description of a tube-in-tube design of a pedicled SCIA-based flap.

Introduction: Phalloplasty with urethral lengthening (UL) is a complex procedure with a high complication rate.

Case: A 44-year-old transgender man with a surgical history of mastectomy, hysterectomy, bilateral oophorectomy, colpectomy and metadoioplasty with UL wished to undergo phalloplasty with UL. He had lost 50 kgs of weight for this procedure.

Higher physical activity levels are related to faecal microbiota diversity and composition in young adults.

Increasing physical activity (PA) is recognised as an efficacious approach for preventing and treating cardiometabolic diseases. Recently, the composition of microorganisms living within the gut has been proposed as an important appropriate target for treating these diseases. Whether PA is related to faecal microbiota diversity and composition in humans remains to be ascertained.

Fixing the earth: whole-systems thinking in Silicon Valley's environmental ideology.

Today, American tech actors express optimistic ideas about how to fix the Earth and halt climate change. Such "green" initiatives have in common that they capture the world in systems and propose large systemic, and mostly technological, solutions. Because of their reliance on techno-fixes, representatives of Silicon Valley express an ideology of ecomodernism, which believes that human progress can be "decoupled" from environmental decline.

The Associations Between Temperament and Self-Oriented, Other-Oriented, and Dual-Harmful Behaviors in Emerging Adults.

Self- and other-oriented harmful behaviors are common among emerging adults. Individuals who engage in both forms of behavior, termed dual-harm, experience more adverse outcomes in comparison to individuals who engage in either. This study examines temperamental traits, defined as reactive and regulative temperament, as transdiagnostic factors underlying engagement in self-oriented, other-oriented, and dual-harmful behaviors.

DNA Methylation Associates With Sex-Specific Effects of Experimentally Increased Yolk Testosterone in Wild Nestlings.

Maternal hormones can profoundly impact offspring physiology and behaviour in sex-dependent ways. Yet little is known about the molecular mechanisms linking these maternal effects to offspring phenotypes. DNA methylation, an epigenetic mechanism, is suggested to facilitate maternal androgens' effects.

Surgical Management of Intracerebral Hemorrhage: New Light on the Horizon?

After 30 years of disappointment, 2 randomized controlled trials investigating the effect of neurosurgical treatment on functional outcome in patients with intracerebral hemorrhage were published in 2024. The ENRICH trial (Early Minimally Invasive Removal of Intracerebral Hemorrhage) studied the efficacy of early minimally invasive hematoma removal in patients with lobar or anterior basal ganglia intracerebral hemorrhage, whereas the SWITCH trial investigated the effect of decompressive craniectomy without hematoma removal in severe deep intracerebral hemorrhage. In this critique article, we will discuss the main findings of these trials, their implications and future perspectives.

Predicting Antidepressant Treatment Response From Cortical Structure on MRI: A Mega-Analysis From the ENIGMA-MDD Working Group.

Accurately predicting individual antidepressant treatment response could expedite the lengthy trial-and-error process of finding an effective treatment for major depressive disorder (MDD). We tested and compared machine learning-based methods that predict individual-level pharmacotherapeutic treatment response using cortical morphometry from multisite longitudinal cohorts. We conducted an international analysis of pooled data from six sites of the ENIGMA-MDD consortium (n = 262 MDD patients; age = 36.

Epidemiology of invasive disease in adults in England, 2013-2017.

Extraintestinal pathogenic (ExPEC) causes invasive disease (IED), including bacteraemia and (uro)sepsis, resulting in a high disease burden, especially among older adults. This study describes the epidemiology of IED in England (2013-2017) by combining laboratory surveillance and clinical data. A total of 191 612 IED cases were identified.

The Impact of Chemotherapy and Body Mass Index on Cancer-Related Fatigue in Colon Cancer Patients: A PROFILES-Registry Study.

Background: Inflammation has been reported to drive cancer-related fatigue (CRF). As both obesity and chemotherapy promote inflammatory responses, obese cancer patients may be at risk of more severe CRF, especially when receiving chemotherapy.

Methods: We analysed data of 333 colon cancer patients from four hospitals in the Netherlands (data derived from the PROCORE study).

Consensus findings of an International Workshops on Genotoxicity Testing workshop on using transcriptomic biomarkers to predict genotoxicity.

Gene expression biomarkers have the potential to identify genotoxic and non-genotoxic carcinogens, providing opportunities for integrated testing and reducing animal use. In August 2022, an International Workshops on Genotoxicity Testing (IWGT) workshop was held to critically review current methods to identify genotoxicants using transcriptomic profiling. Here, we summarize the findings of the workgroup on the state of the science regarding the use of transcriptomic biomarkers to identify genotoxic chemicals in vitro and in vivo.

Development and Feasibility Study of a Triage Tool for Early Referral to Spinal Cord Stimulation for Patients With Chronic Low Back and Leg Pain.

Background: In recent years, delayed elective care and growing waiting lists increasingly resulted in postponed surgeries for patients with chronic back and leg pain.

Objective: To develop, implement, and evaluate the feasibility of a triage tool for patients with chronic back and/or leg pain to identify those eligible for referral to spinal cord stimulation (SCS) consultation.

Methods: A triage tool was developed, based on Dutch SCS guidelines, literature review and expert panel consultation.

Asymmetric Microgels with Tunable Morphologies by Assembly-Guided Polymerization of Liquid Crystalline Monomers.

Understanding and controlling the morphology of microgels is crucial for optimizing their properties and functions in diverse areas of application. The fabrication of microgels that exhibit both structural and chemical anisotropy using a template-free approach faces significant challenges. Existing approaches toward such microgels are typically limited to templating methods with low throughput.

Crystal Lattice Analysis for 2D Nanomorphology Prediction of Phase-Separated Materials.

Spontaneous phase separation of materials is a powerful strategy to generate highly defined 2D nanomorphologies with novel properties and functions. Exemplary are such morphologies in block copolymers or amphiphilic systems, whose formation can be well predicted based on parameters such as volume fraction and shape factor. In contrast, the formation of 2D nanomorphologies is currently unpredictable in materials perfectly defined at the molecular level, in which crystallinity plays a significant role.

The [2Fe-2S] cluster of mitochondrial outer membrane protein mitoNEET has an O-regulated nitric oxide access tunnel.

The mitochondrial outer membrane iron-sulphur ([Fe-S]) protein mitoNEET has been extensively studied as a target of the anti-inflammatory and type-2 diabetes drug pioglitazone and as a protein affecting mitochondrial respiratory rate. Despite these extensive past studies, its molecular function has yet to be discovered. Here, we applied an interdisciplinary approach and discovered an explicit nitric oxide (NO) access site to the mitoNEET [2Fe-2S] cluster.

Immunotherapeutic targeting of aging-associated isoDGR motif in chronic lung inflammation.

Accumulation of damaged biomolecules in body tissues is the primary cause of aging and age-related chronic diseases. Since this damage often occurs spontaneously, it has traditionally been regarded as untreatable, with typical therapeutic strategies targeting genes or enzymes being ineffective in this domain. In this report, we demonstrate that an antibody targeting the isoDGR damage motif in lung tissue can guide immune clearance of harmful damaged proteins in vivo, effectively reducing age-linked lung inflammation.

Myotilin gene duplication causing late-onset myotilinopathy.

Background: myotilinopathy is a very rare inherited muscle disease that belongs to the group of myofibrillar myopathies. These diseases share a common alteration of the sarcomere organization at the level of the Z disk resulting in pathological protein aggregation, autophagic abnormalities, and ultimately muscle degeneration. Most reported cases are due to dominant missense mutations in the MYOT gene, two of which are largely recurrent.

Parenteral nutrition and bioelectrical impedance analysis estimated fat-free mass in adult patients with chronic intestinal failure: A descriptive cohort study.

Background: In patients with chronic intestinal failure, the content and type of parenteral nutrition are individually determined based on various factors, including body composition. In clinical practice, bioelectrical impedance analysis is used to assess body composition using standardized protocols. However, these protocols lack specific recommendations for patients receiving parenteral nutrition.

Carbapenemase-Producing Enterobacterales from Patients Arriving from Ukraine in Poland, March 2022-February 2023.

Introduction: Despite a scarcity of data, before 2022 Ukraine was already considered a high-prevalence country for carbapenemase-producing Enterobacterales (CPE), and the situation has dramatically worsened during the full-scale war with Russia. The aim of this study was to analyse CPEs isolated in Poland from victims of war in Ukraine.

Methods: The study included 65 CPE isolates from March 2022 till February 2023, recovered in 36 Polish medical centres from 57 patients arriving from Ukraine, differing largely by age and reason for hospitalisation.

Spatiotemporal Control Over Circadian Rhythms With Light.

Circadian rhythms are endogenous biological oscillators that synchronize internal physiological processes and behaviors with external environmental changes, sustaining homeostasis and health. Disruption of circadian rhythms leads to numerous diseases, including cardiovascular and metabolic diseases, cancer, diabetes, and neurological disorders. Despite the potential to restore healthy rhythms in the organism, pharmacological chronotherapy lacks spatial and temporal resolution.

Assessment of Coronary Microcirculation with High Frame-Rate Contrast-Enhanced Echocardiography.

Objective: Assessing myocardial perfusion in acute myocardial infarction is important for guiding clinicians in choosing appropriate treatment strategies. Echocardiography can be used due to its direct feedback and bedside nature, but it currently faces image quality issues and an inability to differentiate coronary macro- from micro-circulation. We previously developed an imaging scheme using high frame-rate contrast-enhanced ultrasound (HFR CEUS) with higher order singular value decomposition (HOSVD) that provides dynamic perfusion and vascular flow visualization.

Patient-reported outcomes following ciltacabtagene autoleucel or standard of care in patients with lenalidomide-refractory multiple myeloma (CARTITUDE-4): results from a randomised, open-label, phase 3 trial.

Background: In CARTITUDE-4, ciltacabtagene autoleucel (cilta-cel) significantly improved progression-free survival (primary endpoint; previously reported) versus standard of care in patients with relapsed, lenalidomide-refractory multiple myeloma. We report here patient-reported outcomes.

Methods: In the ongoing, phase 3, open-label CARTITUDE-4 study, patients were recruited from 81 sites in the USA, Europe, Asia, and Australia, and were randomly assigned 1:1 to cilta-cel (target, 0·75 × 10 CAR-T cells/kg) or standard of care (daratumumab, pomalidomide, and dexamethasone; pomalidomide, bortezomib, and dexamethasone).